Abstract
BackgroundObservational studies have shown a beneficial effect of obesity on bone health; however, most of those studies were not based on bone biopsies. Metabolic syndrome (MetS) could have an effect on bone remodeling. However, there are no data on the effects of MetS in the presence of renal osteodystrophy.ObjectiveThe aim of this study was to investigate associations between MetS and renal osteodystrophy using the bone histomorphometric turnover-mineralization-volume (TMV) classification.Design, setting, participants & measurementsThis observational cross-sectional study included 55 hemodialysis patients (28 women/27 men) who were evaluated for MetS and bone histomorphometry. Biochemical parameters included calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH), 25-hydroxyvitamin D, free serum leptin, fibroblast growth factor 23 (FGF23), intact osteocalcin, sclerostin (Scl), glucose, insulin, and thyroid hormones. Robust models of multivariate linear regressions were used for the statistical analyses.ResultsFemales had higher iPTH levels (1,143 vs. 358, p = 0.02). Patients with normal bone volume (BV/TV) had a higher prevalence of MetS (73.6% vs. 41.7%, p = 0.02) and higher serum phosphorus, C-terminal FGF23 and insulin levels. The multivariate regression analysis showed that low-density lipoprotein cholesterol (LDL) was positively correlated with bone formation rate (BFR/BS) and negatively associated with mineralization lag time. Bone volume was negatively associated with age but positively associated with MetS. Body mass index (BMI) was not correlated with any of the bone histomorphometric parameters.ConclusionOur results suggest that MetS is not a risk factor for low bone volume in hemodialysis patients. Furthermore, BMI alone was not related to bone volume in this population.
Highlights
The prevalence of obesity more than doubled between 1980 and 2014, and this condition affects 600 million adults globally, which corresponds to 13% of the world’s adult population (11% of men and 15% of women) [1]
The multivariate regression analysis showed that low-density lipoprotein cholesterol (LDL) was positively correlated with bone formation rate (BFR/BS) and negatively associated with mineralization lag time
Bone volume was negatively associated with age but positively associated with metabolic syndrome (MetS)
Summary
The prevalence of obesity more than doubled between 1980 and 2014, and this condition affects 600 million adults globally, which corresponds to 13% of the world’s adult population (11% of men and 15% of women) [1]. The fracture risk in hemodialysis patients is double that in the normal population, and the mortality of these patients is higher than in patients without fractures, regardless of age, duration of dialysis or cardiovascular disease [5]. In this population, a bone biopsy is the gold standard method for evaluating bone volume, turnover and mineralization [6]. Metabolic syndrome (MetS) could have an effect on bone remodeling. There are no data on the effects of MetS in the presence of renal osteodystrophy
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